Hormone treatment is often carried out with the co-operation of the Endocrinology department - the hormone specialists - at UZ Brussel. In theory of fertility
, we learned which hormones form the basis of our fertility and how they organise sperm production in men
- in the brain this is GnRH and the gonadotrophins LH and FSH;
- in the reproductive organs this is chiefly testosterone, the hormone produced by sperm. If sperm production is low, testosterone levels are low and the brains receive the message to step up production of FSH and LH.
Administration of gonadotrophins
In rare cases, such as when the man has Kallman syndrome - there is no production of GnRH in the hypothalamus. As a result, the hypophysis does not produce gonadotrophins and there is no sperm production. The testicles are small like those of a pre-pubescent boy.
To stimulate the production of sperm, gonadotrophin substitutes are injected at a rate of twice a week, for a couple of months. It takes almost three months to produce sperm. This means you need to take the hormones for this amount of time for at least one good sperm sample.
If successful, the sperm sample is collected and used for IVF with ICSI.
The treatment also has a number of side effects and cannot be implemented on a permanent basis.
For this reason it is generally continued just long enough to produce several good sperm samples which are then frozen and stored for later use.
As we can conclude from the bodybuilder story (see the central heating principle
), the administration of testosterone forms no useful role in fertility treatment. Quite the contrary in fact.
This treatment, which can be either in the form of three-weekly injections or daily gel form, is carried out to avoid the unpleasant effects of testosterone deficiency, such as low libido and bone calcification.
A specific group of men who have a testosterone deficiency, are those with Klinefelter syndrome
If a sufferer wishes to father children he must have a TESE
-operation to obtain sperm for ART treatment.
You have to stop the testosterone therapy at least three months before you have a TESE operation.